Digital Commons Network^™

Cortisol Administration Normalizes Aberrant Functional Connectivity In Women With Depression, Adam C. Runyan

Dissertations

Previous resting-state functional connectivity (rsFC) research has identified aberrant connectivity in several large brain networks in depression, including the default mode (DMN), frontoparietal (FPN), and salience networks (SN). Connectivity of these networks is also related to depressive symptom severity and is affected by cortisol levels. To our knowledge, this is the first study to investigate the effects of acute cortisol administration on rsFC of DMN, FPN, and SN in individuals varying in depression history and severity. We collected resting-state fMRI scans for 74 women with and without a history of depressive disorder after administration of cortisol and placebo using a …

Implementing Recova® To Adjust Estimated Dry Weight In An Outpatient Hemodialysis Clinic, Ayomide Aruwajoye

Dissertations

Problem: The purpose of this project is to implement the Recova® tool to adjust estimated dry weight supporting interdisciplinary team management of fluid overload in dialysis patients. Fluid overload can lead to high rates of morbidity and mortality. A total sample of 26 hemodialysis patients in an outpatient clinic located in a metropolitan city in a midwestern state was included in the project. Data collected shows there was poor knowledge familiarity with how fluid should be managed in patients suffering from chronic kidney disease. The nurses utilized the Recova tool for a period of 8 weeks to help aid in …

Factors Influencing The Adoption Of Smart-Home Appliances: Users' Perspectives, Prakash Shahi

Dissertations

Smart appliances will be a significant part of the annual $300 billion smart-home market by 2025. Their use is expected to grow at a compounded annual growth rate of 31% for the foreseeable future. Currently, 12-16% of households use smart-home products in the U.S., including thermostats, TVs, refrigerators, coffee machines, garage door openers, and vision-equipped doorbells. Smart appliances provide significant benefits to us over traditional appliances. Smart appliances simplify our lives by automating various tasks in our homes and allowing us to monitor and control them remotely from our offices, grocery stores, and wherever we may be.

Despite the usefulness …

The Lived Experience Of Parents Of Children With Special Healthcare Needs On Public And Private Insurance: A Phenomenological Study, Regine P. Reaves

Dissertations

Due to recent advances in medical technology, the number of children with special healthcare needs (CSHCN) is steadily growing in the United States. CSHCN comprise more than 40% of overall healthcare costs nationwide, even though this group is only comprised of 16% of the U.S. child population. There are significant differences between private and public health plans in terms of cost, adequacy, and parent satisfaction. As an added benefit, some public and private health insurance plans offer nursing care coordination (or nursing case management) services. The purpose of this study was to understand the experiences of parents of CSHCN enrolled …

The Impact Of Emotional Intelligence On The Leadership Of Chief Human Resources Officers In The California Community Colleges System, Tonya Davis

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of chief human resources officers (CHROs) in the California Community Colleges System regarding the impact of emotional intelligence (EI) on their leadership in four areas: self- awareness, self-management, social awareness, and relationship management.

Methodology: This qualitative phenomenological study described the lived experiences of CHROs as those experiences relate to the impact of EI on their leadership. A random sample was selected from the target population of 24 CHROs located in the Central and Southern Regions of California. The instrumentation used in the study was semistructured interview questions adapted …

The Lived Experiences Of Minority Nursing Students: Perceived Barriers To Success, Strategies For Success, And The Role Of Grit, Sherry Ann Koenigsman

Dissertations

The education and graduation of minority nursing students is needed to meet the healthcare needs of the people of the United States. However, more minority nursing students are lost to attrition than are white students. The purpose of this study was to seek to understand, from the perspective of the minority nursing students themselves, what barriers they face, their strategies for success, and the role grit plays in their nursing school journey.

Adolescent Depression: Experiences And Meanings Of Being Parented And Parenting, Terri Jean Farmer

Dissertations

Major depression affects up to 40% of U.S. adolescents in mild to severe forms, compromising emotional, academic, and relational functioning, including that of interacting with parents. The purpose of this study was to explore the parent-adolescent relationship during an episode of depression in order to elucidate the adolescent experience of being parented and the parental experience as it contributes to the context of the adolescent. Research questions included: 1) What are the depressed adolescent's meanings and experiences of being parented? 2) How do the meanings and experiences of parenting contribute to the context of the lifeworld of the depressed adolescent? …

Lean Accounting: A Connection To Strategic Partnership & Collaboration Between Management Accountants And Operations Managers, Colleen Mpofu

Dissertations

Technological advances, such as automation and artificial intelligence, have transformed the accounting profession. There is a consensus in the academic and practitioner literature that management accountants must move from their traditional role into one that serves as a strategic partner. However, literature that examines how management accountants have moved from this traditional role to one that is more strategic is limited. This study combines concepts from three different literature streams to explore how utilizing lean accounting practices relate to management accountant’s participation in strategic decision making, partnership with operations managers, and overall operational performance in manufacturing firms utilizing a lean …

An Examination Of The Influence Of Select Non-Cognitive Variables On The Intention Of Minority Baccalaureate Nursing Students To Complete A Baccalaureate Nursing Program, Dena B. Evans

Dissertations

On college and university campuses nationwide, understanding the phenomenon of student retention has become an institutional imperative. The loss of any student is costly to a college or university, resulting in considerable financial loss (Siedman, 2005). For some programs of study, such as nursing, retention is paramount, not only for the institution but for the communities which are served by its graduates. Moreover, retaining minority nursing students is of particular importance because it holds the key to the resolution of a long-standing absence of minority representation in the nursing profession, the nursing shortage and the elimination of health disparities among …

Transition Needs, Challenges, Satisfaction, And Support Strategies Of Newly Hired Nurses In The Clinical Setting, Ric-An Artemio S. Gadin

Dissertations

With a looming shortage of nurses in the global scenario, there is a deep concern to address the transitioning of newly hired nurses to become skilled nurses who can deliver essential health services without compromising the safety and effectiveness of patient care. There is an urgent need to effectively prepare these new nurses for the transition to bedside clinical practice. This prompted the researcher to identify the transition needs, challenges, satisfaction, and support strategies of newly hired nurses in the clinical setting. This study utilized a descriptive method of research using a validated self-constructed survey questionnaire to elicit responses from …

Remote Learning - The Future Of Education: Effective Instructional Strategies Used By Parent Educators And Recommendations For Building Capacity, Raelene Ferguson Haugen

Dissertations

Purpose: The purpose of this mixed methods Delphi study was to identify the remote learning instructional strategies used by expert Southern California parent educators for implementing the anticipatory set, modeling, checking for understanding, and guided practice elements of Madeline Cheek Hunter’s Instructional Theory Into Practice (ITIP) framework. The study sought to identify how expert Southern California parent educators rated the effectiveness of the remote learning instructional strategies in the aforementioned elements of Hunter’s ITIP framework. Additionally, the purpose was to generate recommendations from expert Southern California parent educators to build capacity in the identified effective instructional strategies.

Methodology: The classical …

Increasing Rooming-In Rates On A Mother Baby Unit, Scotti Manes

Dissertations

Problem: For new postpartum mothers, rooming-in has much evidence-based benefit; yet it is not widely accepted. Recent trends show the standard of care has changed to have newborns cared for in the nursery during parts of the postpartum period. Healthcare providers have unintentionally lacked providing ample education to new mothers regarding the benefits of rooming-in for mothers and newborns.

Methods: For this quality improvement (QI) project, a descriptive observational study design was used to identify if implementing standardized rooming-in education for patients influences rooming-in rates or the rates of exclusive breastfeeding at discharge. Thirteen staff nurses were identified as “champions” …

An Evaluation Of A Multidisciplinary Implementation Of Evidence Based Practice In Prediabetes, Emily Sisco

Dissertations

Abstract

Problem Over 70% of prediabetic patients progress to full diabetes. There are over 80 million American adults who are diabetic. Diabetes is the costliest chronic disease that often leads to many other health issues.

Methods This QI project utilized a descriptive observational design. Quantitative data was collected via retrospective chart review. Primary data collected was documentation of a patient visit to the registered dietician and the hemoglobin A1c (HbA1c) of patients who followed up in the office after the referral.

Results Eight patients followed up to the office for a second visit (n=8). Four patients did see the registered …

Bee Brains: Dissecting Pollinator Behavior And The Importance Of Plasticity In The Face Of Changing Environments, Rachel Brant

Dissertations

All organisms face environmental variability, and much of contemporary biological research aims to understand the mechanisms allowing organisms to adapt and survive in the face of change. Animals residing in urban habitats face particularly high levels of unpredictability and environmental fluctuation due to changes based upon human desire. Though urban areas are considered relatively novel habitats, numerous species have adapted to city life, mediated through behavioral and physiological plasticity. Native bee species show particularly high species richness and abundance in urban settings, but the mechanisms driving this pattern are poorly understood. In this dissertation, I explore how bees employ plasticity …

Reducing Pediatric Morbidity Through Development Of A Clinical Practice Guideline, Deanna Kroh

Dissertations

Peripheral intravenous therapy is a commonly utilized treatment modality for the care of acutely ill pediatric patients. Two risk factors include infiltration and extravasation injuries. These injuries, peripheral intravenous infiltration or extravasation injuries (PIVIEs), can vary in their clinical manifestations from minor discomfort to harm as severe as loss of limb or disfigurement. Clinicians caring for patients at risk of developing PIVIEs need to be able to act quickly to reduce potential morbidity. The purpose of this project was to create a clinical practice guideline (CPG) that would guide staff intervention if a PIVIE occurs, with the ultimate goal of …

Implementation Of An Evaluation Of Davita Clabsi Protocol To Reduce Bloodstream Infections In Acute Hemodialysis Patients, Emmy Le

Dissertations

Abstract

Problem: Central line-associated bloodstream infection (CLABSI) is the primary cause of morbidity and mortality in End-Stage Renal Disease (ESRD) patients on hemodialysis. It is associated with severe medical conditions, prolonged hospitalization, and financial burden. Despite its convenience and simple operation, central venous catheter (CVC) account for 70% of all CLABSI occurrence and increase the risk for septicemia and death.

Methods: This quality improvement (QI) project utilized a descriptive observational pilot design to identify the effect of DaVita CLABSI Protocol on CLABSI occurrence rate. Quantitative data was collected retrospectively and prospectively via electronic medical record (EMR) review before and …

Education To Improve Long-Acting Injectable Antipsychotic Use, Travis Donald Wolfangel

Dissertations

Purpose: Long-acting injectable (LAI) antipsychotics are underutilized as an evidence-based treatment for schizophrenia and schizoaffective disorder. The purpose of this quality improvement project was to determine if a web-based LAI education module changed advance practice prescribers’ knowledge, attitudes, and practice behaviors regarding LAI antipsychotics one month after receiving LAI education at a community-based mental health organization.

Methods: This QI project was an observational pre- post-educational design. The 20-item Knowledge, Attitudes, and Practices (KAP) questionnaire was used to assess advanced practice providers’ knowledge retention, attitude changes, and practice modifications regarding LAI antipsychotics and prospective patient chart reviews were performed. …

Evaluation Of An Education Program Implementation For Adults With Stage 4 And 5 Chronic Kidney Disease, Dana Marie Carter

Dissertations

Abstract

Problem: Patients with long-term medical conditions represent a significant public health issue. Therefore, patients diagnosed with a chronic illness must have a high level of health literacy (HL) to manage their condition effectively. This Quality Improvement (QI) project evaluated the impact of an existing education-based program for stage 4 and 5 chronic kidney disease (CKD) patients and its effect on laboratory values compared before and after an NP-led education program that included vascular access, and modality choices.

Methods: A retrospective chart review was completed on 20 patients with an inclusive diagnosis of CKD stage 4 or 5 from …

Implementing A D/Deaf Educational Module For Graduate Nursing Students, Brenda J. Pauley

Dissertations

Problem: Nurse practitioners lack knowledge and skills to effectively communicate with D/deaf individuals which potentiates risk for health disparities and gaps in care. Graduate nursing programs rarely incorporate D/deaf-focused education in their curriculums.

Methods: This descriptive quality improvement project implemented the first D/deaf-focused educational online module at a Midwestern university’s College of Nursing. A purposive sample of 38 BSN-DNP students enrolled in the Spring Intensive completed a pre- and post-education survey. Both surveys assessed students’ D/deaf perceptions through Lewis and Keele’s (2020) D/deaf and Hard of Hearing Interaction Beliefs Scale for Registered Nurses (DdHH-IBS/RN) and evaluated students’ knowledge through a …

The Impact Of Music Education On Middle School Students’ Attendance Rates And Academic Achievement On Math And English Language Arts, Irene Wang Shi

Dissertations

In recent years, students’ standardized test scores have become one of the major measurements for students’ learning. However, music as a non-tested subject is often viewed as a lesser valued subject compared to core subjects. The purpose of this study was to investigate the impact music programs have on student academic achievement and attendance rate. The data was collected from one middle school of a large school district located in the northeast of Missouri. The study population includes sixth, seventh, and eighth-grade students who enrolled in the 2017-2018, 2018-2019, and 2020-2021 school years. The population was divided into students who …

Implementation Of A Critical Event Debriefing Tool In The Pediatric Intensive Care Unit, Tara Fiala

Dissertations

Problem: Working in the Pediatric Intensive Care Unit (PICU), staff encounter critical patient events without warning. Debriefing after adverse patient events has been shown to give staff the opportunity to process these events in an open, honest, and judgement-free environment. Debriefing has been recognized as a tool for detecting medical errors, improving team communication, providing emotional support, and analyzing team performance.

Methods: A descriptive, observational pilot study was used to implement the DISCERN tool into a large, midwestern, urban PICU. The aim of the quality improvement project was to achieve a debriefing tool completion rate of 20% over a one-month …

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Healthcare-Associated Pressure Injury Prevention In The Intensive Care Unit, Ross Quinton

Dissertations

Problem: Healthcare-associated pressure injuries (HAPIs) occur when prolonged pressure is on the sacrum, coccyx, elbows, and heels, during a hospital stay. HAPIs can result in increased morbidity and mortality, and prolonged hospital stays, which consequently requires excess expenditure on treatment. Early specialty mattress placement can prevent HAPI acquirement.

Methods: This quality improvement (QI) pilot project aimed to increase specialty prevention mattress usage in the intensive care unit (ICU). A sleep surface decision tree was implemented into the admission process in a 30-bed ICU. A retrospective record review was used to examine demographics, comorbidities, HAPI risk, length of stay, and when …

Effect Of A Turn Clock On Hospital-Acquired Pressure Injury Incidence, Sydney Warren

Dissertations

Problem: Hospital-Acquired Pressure Injuries (HAPIs) are the only quality metric increasing in incidence and are preventable. HAPIs are wounds to bony prominences during a hospitalization and can increase hospital costs, morbidity, and mortality. HAPIs could be prevented through interventions, including repositioning patients every 2 hours and using a turn clock method. The aim of this quality improvement (QI) pilot project was to decrease HAPI incidence.

Methods: A turn clock method was implemented on a general medicine floor at a mid-sized, suburban medical center utilizing a descriptive retrospective observational design. Data was collected for the pre-intervention timeframe from June through August …

Lifting As We Climb: Giving Voice To Black Female Mentorship Stories And Exploring Factors That Lead To Successful Mentoring Outcomes, Channon Peoples, Margaret Brockmeyer, Dawn Indelicato-Faw

Dissertations

As researcher-practitioners, we noted that the literature on mentorship has increased dramatically in recent years. However, the literature lacks attention to female paired mentoring relationships, especially relationships between women of color. Although we did not initially set out to fill this gap, our research does bring attention to the power of mentorship relationships between women of color. We explore three critical factors of an effective, female mentor-mentee relationship: social capital development (i.e., expand networks, build relationships), social and emotional learning (i.e., strengthen emotional resilience, increase self-awareness), and awareness of intersectionality (i.e., interact with role models, draw upon one’s unique identities). …

Implementing Patient Acuity Scale On A Medical-Surgical Unit, Coreen Ladd

Dissertations

Problem: Nurses commonly report dissatisfaction with their workload levels due to inequity of shift assignments. Imbalanced workload distribution has been shown to lead to missing or delayed care. Increased nursing workload has been linked to increased fall rates, healthcare associated infections, and avoidable deaths. Research has shown that patient classification is more accurate when an instrument is used. The purpose of this quality improvement project was to implement a patient acuity tool to aid nurse-patient shift assignments on a medical-surgical unit. The project aimed to provide a standardized and objective method of measuring patient acuity.

Methods: The project took place …

Effect Of A Trauma Informed Care Tool In A Pediatric Cardiac Intensive Care Unit, Taylor Park

Dissertations

Problem: Parents of infants less than one-year-old with complex congenital heart disease (CCHD) experience significant stress while their child is admitted to the pediatric cardiac intensive care unit (PCICU), often resulting in trauma to parents and their families. Trauma informed care (TIC) seeks to minimize the impact of emotional trauma and it acknowledges previous trauma an individual may have experienced.

Methods: The purpose of this quality improvement (QI) project was to assess the thrive guide’s ability to decrease parental stress in the pediatric cardiac intensive care unit (PCICU). The aim was to decrease parental Perceived Stress Scale (PSS) scores by …

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Evaluating The Effectiveness Of Implementing Depression Screenings With Uninsured African American Adults, Pamela Talley

Dissertations

Problem: Uninsured African Americans are underdiagnosed and often untreated for depression. Individuals usually do not present to their primary care provider with a complaint of depressed mood, however, may report symptoms such as decreased energy, general body aches, digestive concerns, somatic complaints, or older adults' memory or cognitive problems. The purpose of this quality improvement pilot project was to examine the results of the implementation of a depression screening (PHQ-9) in a primary care setting for uninsured adults for detection, diagnosis, and treatment of depression in African American clients.

Results: The PHQ-9 screening questionnaire was given to 100% (N …